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STUDY ABROAD SCHOLARSHIP/ INTENT FORM
University Honors College
Name
Student ID No.
MTSU E-Mail Address
Cell Phone
Major(s)
Minor
Total Hours Completed
Total HONORS Hours Completed
Class Level
Graduation Date
GPA
Destination
Trip Dates
What is the length of your study abroad program?
Less than a month (30 days)
1-2 months
2-3 months
Include month, dates, and year
full semester
Please indicate the term for which you plan to study abroad:
Fall
Spring
Summer
Winter Term
full academic year
Academic Year (Fall and Spring)
My hours should transfer in as:
Lower-Division
Course Title(s):
Upper-Division
Split between Upper- and Lower-Division
(IMPORTANT NOTE: If your course(s) are not known prior to your trip, you cannot request interdisciplinary credit)
Once completed courses have been posted to your transcript, they will be evaluated to determine if they
transferred as lower- or upper-division. A maximum of nine (9) hours may be counted as Honors credit.
Honors interdisciplinary credit is requested for three (3) hours. The course must meet one or more of the
bulleted criterion below. If you do know your course(s), you must attach supporting documents as
justification and explanation (syllabus, brochure, etc.).
Course will be taught in a language other than English
Course covers topic(s) not readily available at MTSU
Course covers ethics/culture of the country
Course must be 3000 or 4000 level
Applicant will be student teaching in a foreign country
Course is interdisciplinary in nature (e.g., literature and history; art and music)
I would like to be considered for Honors Study Abroad Scholarships.
The deadlines are:
Awards require
Winter programs: September 30
final approval
Spring programs: October 30
by the Financial
Summer programs: January 30
Aid office.
Fall or Year-long programs: February 28
Yes
No Are you a Transfer Fellow?
Are you a Buchanan Fellow?
Yes
No
Have you participated in a Study Abroad Program before?
Yes
No
You must have a signature from the Education Abroad Office before submitting your
application (they are located in Peck Hall 207). Please return signed form to April Goers,
Honors College Building, Room 228.
Education Abroad Signature
Current Date
STAFF NOTES: Amount Awarded: $
Honors College Academic Advisor
Honors College Dean or Associate Dean
STAFF NOTES: Priority Registration
Yes
No